StayCurrentMD · Bleeding Meckel's Diverticulum: Update Course 2015
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Video4 min·Published Jul 2017Older

Bleeding Meckel's Diverticulum: Update Course 2015

Chapter 1 of 3 · Diagnosis & Workup

Negative Meckel scan

Diagnostic approach after negative Meckel scan

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Hematochezia
What the experts said8 expert statements · 1 host summary
PPI therapy will stop bleeding from a Meckel's diverticulum.
Clinical
Bleeding Meckel's diverticulum should never be an emergency operation.
Opinion
After stapling off a Meckel's diverticulum, the bleeding ulcer is still present and the patient may continue bleeding for the next day.
Clinical
Removing the Meckel's diverticulum eliminates the source of acid causing the ulcer, analogous to performing vagotomy for duodenal ulcer.
Clinical
The bleeding ulcer is almost always at the tip of the Meckel's diverticulum.
Clinical
When stapling a Meckel's diverticulum laparoscopically, pulling it up to staple creates a tendency to encroach onto the bowel.
Clinical
Pulling a Meckel's diverticulum out through the umbilicus and marking the resection line without tension prevents distortion of anatomy.
Clinical
With a linear staple line across a Meckel's base, slight impingement on the bowel does not matter because the bowel will dilate out, unless a huge stricture is created.
Clinical
Bill Gazetta taught that the ulcers in bleeding Meckel's diverticulum are located within the Meckel's itself, not in the adjacent small bowel.
Host summaryThe host summarizing the discussion · not cited in answers